摘要
目的对耐碳青霉烯鲍氏不动杆菌(Carbapenem-resistant Acinetobacter baumannii,CRAB)血流感染的影响因素进行综合评价,为临床预防和控制感染提供依据。方法使用计算机检索国内外数据库PubMed、Embase、中国知网(CNKI)、万方、维普、中国生物医学文献数据库(CBM)等,辅以互联网络检索,手工检索初步入选文献的全文。收集国内外公开发表的关于耐碳青霉烯鲍曼不动杆菌血流感染的影响因素的相关文献,选择符合标准的临床资料。由两名研究者按照纳入和排除标准筛选文献并提取资料,参考Newcastle-Ottawa Scale的质量评价标准进行质量评价,使用CMA软件进行Meta分析。结果共15篇文献入选本研究,累计1 893例,对15个影响因素进行分析,其中有11个因素差异具有统计学意义,分别是深静脉置管(OR=2.581,95%CI=1.630～4.086)、气道开放(OR=3.370,95%CI=2.015～5.637)、基础疾病(OR=2.587,95%CI=1.711～3.913)、使用≥2种抗菌药物(OR=3.014,95%CI=1.636～5.550)、留置导尿管(OR=2.656,95%CI=1.382～5.014)、使用碳青霉烯类抗菌药物(OR=2.683,95%CI=2.017～3.570)、留置鼻胃肠管(OR=2.335,95%CI=1.220～4.467)、胃肠外营养治疗(OR=2.835,95%CI=1.648～4.876)、有原发感染灶(OR=4.219,95%CI=1.274～13.974)、APACHEII评分≥22分(OR=8.332,95%CI=2.836～24.481)、入住ICU≥2周(OR=2.835,95%CI=1.391～5.776)。结论应对CRAB血流感染的影响因素采取针对性措施,减少和预防CRAB血流感染的发生。
OBJECTIVE To comprehensively evaluate the influencing factors o￡ bloodstream infection caused by carbapenem- resistant Acinetobacter baumannii (CRAB), so as to provide evidence for the prevention and control of infection. METHODS The PubMed, Embase, Chinese biomedical literature database (CBM), Wanfang, Weipu and CNKI databases were searched by computer, supplemented by Internet retrieval, and the full text of the initially selected literatures were subjected to manual retrieval.The related literatures about the factors influencing the bloodstream infection caused by carbapenem-resistant A baumannii were collected, and the clinical data that met the standard were selected. Two researchers screened the literature according to the inclusion and exclusion criteria and extracted the data. Quality evaluation was conducted by referring to the quality evaluation standard of Newcastle- velocity Scale, and Meta analysis was conducted using CMA software. RESULTS Totally 15 articles were included in this study. The total of 1893 cases were analyzed for 15 influencing factors, and 11 factors showed significant differences, including deep vein catheterization (OR = 2.581 , 95%CI= 1.630-4.086), airway open (OR = 3.370, 95%CI= 2.015-5.637), underlying diseases (OR =2.587, 95%CI = 1.711 -3.913), use of two or more kinds of antimicrobial agents (OR = 3.014, 95%CI= 1.636-5.550), indwelling catheters (OR = 2.656, 95%CI = 1.382-5.014), use of carbapenems (OR = 2.683, 95%CI = 2.017 -3.570), nasal gastrointestinal tube (OR = 2.335 , 95%CI= 1.220 -4.467), parenteral nutrition (OR = 2.835 - 95 %CI = 1.648 -4.876), primary infection focus (OR = 4.219). 95%C7 = 1.274-13.974), APACHEII score greater than or equal to 22 (OR =8.332, 95% CI = 2.836-24.481), and ICU entry rate greater than or equal to 2 weeks (OR = 2.835, 95%CI= 1.391-5.776). CONCLUSION We should take measures according to the risk factors for CRAB-associated bloodstream infection, so as to reduce and prevent the occurrence of CRAB-associated bloodstream infection.
作者
胡兰兰
李颖
邵中军
吉兆华
范珊红
HU Lan-Ian;LI Ying;SHAO Zhong-jun;JI Zhao-hua;FAN Shan-hong(Tangdu Hospital of Military Medical University of the Air Force , Xi'an , Shanxi 710038 , China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第8期1136-1141,共6页
Chinese Journal of Nosocomiology
基金
陕西省社会发展科技攻关基金资助项目(2016SF-144)
空军军医大学第二附属医院医院管理与服务创新基金资助项目(2017YG-026)
关键词
鲍氏不动杆菌
耐碳青霉烯
血流感染
影响因素
META分析
Acinetobacter baumannii
Carbapenems resistant
Bloodstream infections
Influencing factors
Meta analysis
